Chemical Eye Injury Case Study

Abstract:

Chemical eye injury is a common ophthalmic emergency which needs an immediate and aggressive management to maximize visual outcome. The outcome ranges from full recovery to a permanent loss of vision. Available options for treatment include medical and surgical interventions. Our case is a young adult male who had a grade II alkali burn in his right eye after an accidental exposure to chemical powder at work. He was medically managed aggressively after admission to a medical ward at King Hamad University hospital with good outcome. Herein, we will discuss and focus in different methods of proper chemical eye injuries management according to degree of ocular damage.

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The outcome ranges from full recovery to a permanent loss of vision. Chemical eye injuries happen with exposure to alkali or acidic agents, solvents & irritants. Alkali injuries occur more frequently. Available options for treatment include medical and surgical interventions

His best corrected visual acuity was 6/9 in the affected eye while 6/6 in the left eye. Right eye examination revealed a lower lid grade 1 burn 20 X 10mm with ulceration around the eye lashes (Figure 1 a). Bulbar conjunctiva had a similar burn inferior to cornea measuring 15 x 9mm. Limbal ischemia was from 5 to 7 o clock (Figure 1 b). Cornea was hazy with visible iris details. There was corneal epithelial loss, which extended a vertical line from 4 to 11 o clock to the limbus (Figure 1 c). Anterior chamber was deep and quite, lens was clear, there was hazy fundus view showing flat retina. The left eye had normal anterior & posterior chambers on examination.

The patient was diagnosed as grade II alkali chemical eye injury. The plan of management was to admit the patient with the following treatment: preservative-free artificial tear drops every 1 hour, erythromycin eye ointment every 2 hours, moxifloxacin eye drops every four hours, Tobradex eye drop ( tobramycin + dexamethasone 0.1%) every 6 hours & cyclopentolate eye drops every 8